Introduction/Background One of the most important tasks of modern oncogynecology is the implementation of organ-sparing treatment of young patients and the preservation of reproductive function.
Methodology From 2008 to 2019 in the oncogynecological department of the N.N. Petrov National Research Center performed 43 radical trachelectomies (IA1-IB1 stages): 27 - abdominal trachelectomies and 13 - Dargent’s operations and 3 - laparoscopic trachelectomies. The average age of patients is 30.2±4 years. According to the results of histological examination squamous cell carcinoma was verified in 90% of cases, adenocarcinoma in 10%.
Results The duration of radical trachelectomy ranged from 150 to 360 minutes, the volume of blood loss ranged from 50–1600 ml. The early postoperative period in all patients proceeded without complications. Among the late postoperative complications were recorded: asymptomatic lymphocytes (n=6), lymphedema (n=2), cervical stenosis (n=5). In all patients after surgery, menstrual recovery occurred in the period from 2 to 2.5 months. The uterovaginal anastomosis healed in 2–3 months. The observation period ranged from 3 months to 10 years. Four recurrences of cervical cancer after organ-preserving treatment were established in IB1 stage of the disease after 5 (anastomosis zone), 6 (pelvic wall), 11 (carcinomatosis) and 13 (pelvic wall) months. Three patients died from the progression of the disease. Overall survival was 92% when performing radical trachelectomy. Pregnancy occurred in 8 patients. In five women pregnancies resulted in cesarean section in the third trimester, and three pregnant women had miscarriages in the first trimester. Nineteen patients refused pregnancies due to fear of recurrence of the disease, lack of a partner. Nine women are planning a future pregnancy.
Conclusion The literature data and our experience show that radical trachelectomy is an effective type of organ-preserving treatment for patients with cervical cancer of the initial stages.
Disclosure Nothing to disclose.
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